Abstract
Tension-type headache is a highly prevalent primary headache disorder. Progress and advances in basic and clinical research has improved our understanding of pathophysiology of this condition. At this point, we know that both peripheral (muscles and nociceptors) and central (nociceptive pathways) are involved in mechanisms of tension-type headache. Pericranial myofascial pain sensitivity is increased in patients with tension-type headache. Thus, peripheral sensitization of myofascial nociceptors may play a role in the increased pain sensitivity. With certain risk factors involved, the transformation of episodic to chronic tension-type headache, i.e., chronification, may be caused by both central sensitization and deficient descending inhibition. Nitric oxide may play a key role in the pathophysiology of tension-type headache, and nitric oxide synthase inhibitors may become a future treatment option for chronic tension-type headache.
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